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<br />~1 <br />P~ ~QPC <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: PK Enterprises, In/c.~~ <br />PERMIT NO.: M-2000-077 ,/ <br />OPERATION NAME: Mule Creek Pit <br />ANNIVERSARY DATE: October 12, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Teller <br />R~~~~~~® <br />~;w~~''tOp' / <br />Mining ~§~~9»,. <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />- - -shay-submit-the-annual-fee; e-report-and-map-showing-the_extent_of current_disturbances_ta_affecSed land,__ _ <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. If no new disturbances or reclamation have occurred during the urevious vear and no new chances to <br />the arevious year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Gregory A. Loop <br />Permittee Name: PK Enterprises, Inc. <br />Address: 11115 W. Hwy. 24, Unit 2A <br />P.O. Box 729 <br />Divide, CO 80814 <br />Phone Number: <br />Fax Number: <br />(719)686-1566 <br />(719)687-6788 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature f C rate fficer caner, or Designee <br />,o-ice-~~ <br />Date <br />